By Holly Bengfort on September 11, 2026 at 9:00 AM
Health insurance can be a lifeline in times of need. But its intricacies often leave people confused and anxious. This can make purchasing a health plan during Open Enrollment (OE) feel overwhelming. Whether you're shopping for health coverage for the first time or reevaluating your current plan, being well-informed is key.
In this article, we'll guide you through ten simple steps to help you choose a health plan.
In this blog post, you'll learn:
- How the OE period works.
- How to compare health plan options to find the best one for you.
- If you qualify for a special enrollment period.
1. Know where you can buy individual health insurance
The Affordable Care Act (ACA) created a competitive market for individual insurance known as the federal Health Insurance Marketplace, or HealthCare.gov. Individuals and families can get coverage during Open Enrollment through the ACA marketplace or through state-run marketplaces. You can work with an insurance broker or insurance carrier directly, or buy a plan from a private exchange.
Off-exchange plans can provide additional features depending on your needs. For example, some carriers offer specialized off-exchange plans for specific health conditions. However, they can be harder to find on your own.
If your employer uses PeopleKeep by Remodel Health to administer your CHOICE Arrangement (formerly known as ICHRA) or QSEHRA benefit, you can shop for a health policy right from your user dashboard. You can also get help from a licensed Benefit Advisor. In some cases, your employer might work with an insurance broker to help you choose and enroll in a policy instead.
2. Understand the Open Enrollment period
OE for health insurance refers to the period when individuals can enroll in or make changes to their individual health insurance plans.
OE is a crucial time for individuals, especially those who may have experienced changes in their circumstances, such as:
- Job changes
- Family member additions
- Financial shifts
During OE, people can enroll in new coverage, switch plans, or make changes to their existing coverage without needing a qualifying life event.
According to HealthCare.gov, OE for the 2027 coverage year starts on November 1. December 15 is the last day to enroll in or change plans for a January 1 coverage start date.
It’s important to note that enrollment dates for the 2027 coverage year remain subject to ongoing legal proceedings1. Federal rules2 have been issued and challenged that would shorten the annual Open Enrollment period beginning with the 2027 coverage year. In June 2026, a federal court vacated the shortened Open Enrollment provision from a 2025 federal rule, and the decision is currently under appeal. In July 2026, the court also stayed a similar provision in a subsequent 2027 federal rule. For now, the federal Marketplace is operating under the traditional Open Enrollment schedule, but enrollment deadlines could change. Consumers should check their state’s official insurance marketplace for the most up-to-date deadlines before enrolling.
Some states, like California and New York, have extended OE periods. Make sure to check the annual window for your area.
Outside of OE, individuals can only enroll in health insurance if they experience a qualifying life event. Qualifying life events include moving to a new rating area, marriage, and the birth of a child, among others. This makes the OE period essential for accessing healthcare coverage.
If your employer offers you a CHOICE Arrangement (previously known as ICHRA) or QSEHRA for the first time outside of OE, this creates a 60-day special enrollment period (SEP).
3. Gather necessary information
During the application period, you should have the following information on hand:
- Personal details like your name, ZIP code, and Social Security number to verify your identity. You'll also need the Social Security numbers for all household members you plan to include under your policy.
- Income details (such as W-2 forms or pay stubs). This helps the Marketplace determine eligibility for subsidies or specific plan options.
- Information about your current health insurance plan, if you have one already.
- Any relevant medical records or documentation to determine the best plan for your needs. Individual health plans don't take pre-existing conditions into account, so you won't be denied coverage for them. However, tobacco use can impact how much you'll pay.
- Any preferred healthcare providers and specialists to ensure they're in-network and covered under the selected plan.
- Any prescriptions you need your plan to cover. Most exchanges allow you to filter plans based on these prescriptions.
4. Evaluate your current health needs
Before enrolling, assess your healthcare needs. Are you generally healthy? Or do you have chronic health issues?
Consider factors such as:
- The number of doctor visits you have annually
- Any ongoing medical conditions
- Necessary prescriptions
This will help you choose a plan that best fits your requirements during OE.
5. Consider your healthcare providers
When picking a health insurance plan, you want to consider healthcare providers for several reasons. First, your choice of providers impacts the accessibility and quality of medical care you receive. Different insurance plans have varying networks of doctors, specialists, and hospitals. Choosing a plan that includes your preferred healthcare providers can ensure continuity of care.
Second, out-of-network providers often incur higher out-of-pocket expenses. Many plans don’t cover out-of-network providers at all. This can lead to unexpected costs. By examining the provider network associated with each health plan, you can avoid situations where you face additional fees for seeking care outside the network.
Lastly, some plans offer additional resources or benefits through their provider relationships, such as coordinated care programs, preventive services, and specialized treatment options. By considering these additional details when choosing a plan, you can secure a system that aligns with your health needs and maximizes your insurance benefits.
6. Check your eligibility for financial help
Low-income individuals may qualify for premium tax credits3, also known as health insurance subsidies. These extra savings can result in lower monthly premium rates and out-of-pocket costs for medical services.
However, premium tax credits are only available for on-exchange Marketplace coverage. Plans purchased outside the Marketplace aren't eligible for premium tax credits or other Marketplace savings.
By understanding eligibility requirements, such as income level and household size, you can effectively compare different health insurance plans. This helps you choose one that meets your needs while staying within your budget. If you don't check if you qualify for tax credits, you're missing out on potential financial assistance for healthcare costs, which affects your overall well-being and financial stability.
If your employer offers you an affordable CHOICE Arrangement (ICHRA) or QSEHRA allowance, you can't collect any premium tax credits. However, if your CHOICE Arrangement is unaffordable, you can opt out of the benefit and collect any tax credits you qualify for. With an unaffordable QSEHRA, you must reduce any tax credits by the amount of your allowance.
7. Learn key health insurance terms
When searching for a plan during OE, you'll likely come across various terms you haven't heard before. You'll want to ensure you understand these terms before selecting a plan.
Some common health insurance terms include:
- Deductibles
- Coinsurance
- Copayments or copays
- Health maintenance organizations (HMOs)
- Preferred provider organizations (PPOs)
- Point of service plans (POSs)
- Exclusive provider organizations (EPOs)
8. Research a variety of health insurance plans and compare the cost of coverage
Research the various insurance plans available in your area. You can typically do this through federal or state-run marketplaces. Before you buy individual health insurance, you should familiarize yourself with the various metal tiers of plans.
There are four metal tiers of health insurance plans, ranked from lowest to highest average premium cost:
- Bronze plans
- Silver plans
- Gold plans
- Platinum plans
Although all ACA marketplace plans provide the ten essential health benefits, they vary in terms of what you pay and what your health insurer covers for healthcare expenses.
Don't just look at health insurance premiums. If you do, you might be swayed by a plan with a cheaper monthly premium that may cost you more in the long run. You also want to consider other costs associated with the plan, such as deductibles, copayments, and the provider network. A lower premium rate might mean higher out-of-pocket costs when you need medical care.
If your employer offers a CHOICE Arrangement (ICHRA) or QSEHRA, you also need to consider which plans you need to participate in the benefit. In both cases, you'll need a health plan that meets minimum essential coverage (MEC) standards. However, the ICHRA requires you to have a qualifying individual plan, while the QSEHRA only requires MEC. All health insurance plans on the public exchanges meet this standard, but those available directly from a carrier may not.
If you plan to contribute to a health savings account (HSA), you’ll need to enroll in an HSA-qualified high deductible health plan (HDHP). All on-exchange Bronze and catastrophic plans (and the same off-exchange versions) are HSA-qualified.
Finally, review each plan’s summary of benefits and coverage (SBC) and drug formulary to ensure the coverage meets your needs.
9. Enroll online or seek help
During OE, you can enroll online through the healthcare marketplace or with an insurance company. However, if you prefer assistance or have enrollment questions, consider working with a health insurance broker or health benefits navigator. Both brokers and navigators can help you apply for premium tax credits and compare marketplace plans for free.
If your employer offers you an HRA through PeopleKeep by Remodel Health, you’ll have access to our integrated shopping platform and licensed Benefit Advisors.
10. Take note of special enrollment periods
If you miss the OE period, you may still be able to sign up for or change your coverage if you qualify for a special enrollment period (SEP) due to life changes.
The four basic types of qualifying events are:
- Loss of health coverage
- Offer of a new health benefit
- Changes in household
- Changes in residence
You also qualify for an SEP if you:
- Gain membership in a federally recognized tribe
- Become an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder
- Begin or end service with AmeriCorps State, AmeriCorps National, VISTA, or NCCC
Additionally, you may be eligible for a SEP if you qualified in the past 60 days but missed your health plan enrollment deadline because of a natural disaster or a national or state emergency.
What to do after you purchase a health insurance plan
Once you sign up during OE, make sure to check your health coverage every year. Your health needs or financial situation may change, and it's wise to reassess your options each OE period to make sure you have the best plan for your circumstances. You should also set a reminder for when the next OE period begins. This helps you stay up to date and ready to adjust your health insurance coverage if necessary.
After you enroll, you should also keep copies of your enrollment forms and any communication with your insurance provider. This documentation can be helpful in the event of any discrepancies or issues with your coverage.
Additionally, your employer may require proof of your insurance coverage if they offer a CHOICE Arrangement or QSEHRA as a health benefit. With these health benefits, your employer can reimburse you for monthly insurance premiums. This way, they can help you with your own individual insurance coverage instead of buying a group plan for the entire workforce. If the employer allows it, you can also receive reimbursement for more than 200 other eligible out-of-pocket costs, such as preventive care and emergency services.
Conclusion
You're not alone if you're worried about picking the right health insurance plan. There are many factors to think about, and the whole process can feel somewhat daunting. By following these steps, you can navigate the Open Enrollment period with confidence, ensuring you choose the right health insurance plan for you and your family.
This article was originally published on September 23, 2025. It was last updated on September 11, 2026.
References
- hfma: Judge blocks key ACA marketplace rule provisions for 2027
- Litigation Tracker: Civil No. 25-2114-BAH
- IRS: Questions and answers on the Premium Tax Credit
- Healthcare.gov: Special Enrollment Periods for complex issues
